BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitor...BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.展开更多
The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the intera...The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the interaction among decision variables is intricate,leading to large group sizes and suboptimal optimization effects;hence a large-scale multi-objective optimization algorithm based on weighted overlapping grouping of decision variables(MOEAWOD)is proposed in this paper.Initially,the decision variables are perturbed and categorized into convergence and diversity variables;subsequently,the convergence variables are subdivided into groups based on the interactions among different decision variables.If the size of a group surpasses the set threshold,that group undergoes a process of weighting and overlapping grouping.Specifically,the interaction strength is evaluated based on the interaction frequency and number of objectives among various decision variables.The decision variable with the highest interaction in the group is identified and disregarded,and the remaining variables are then reclassified into subgroups.Finally,the decision variable with the strongest interaction is added to each subgroup.MOEAWOD minimizes the interactivity between different groups and maximizes the interactivity of decision variables within groups,which contributed to the optimized direction of convergence and diversity exploration with different groups.MOEAWOD was subjected to testing on 18 benchmark large-scale optimization problems,and the experimental results demonstrate the effectiveness of our methods.Compared with the other algorithms,our method is still at an advantage.展开更多
BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune...BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.展开更多
BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been v...BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.展开更多
The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition...The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition can be influenced.For addressing this issue,a method for extracting ship targets with overlaps via the expectation maximization(EM)algorithm is pro-posed.First,the scatterers of ship targets are obtained via the target detection technique.Then,the EM algorithm is applied to extract the scatterers of a single ship target with a single IPP.Afterwards,a novel image amplitude estimation approach is pro-posed,with which the radar image of a single target with a sin-gle IPP can be generated.The proposed method can accom-plish IPP selection and targets separation in the image domain,which can improve the image quality and reserve the target information most possibly.Results of simulated and real mea-sured data demonstrate the effectiveness of the proposed method.展开更多
BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and asse...BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related death.METHODS Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort study.Liver-related death or transplantation(liver-related mortality)was determined using a population-based data linkage system.Prognostic scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and AIH-PSC.LOS was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any group.CONCLUSION Survival in the rare,AILDOS is unclear.The current study supports the LOS as a predictor of liver-related mortality in AIH-PBC patients.Further trials investigating predictors of survival in AILDOS are required.展开更多
Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive ...Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.展开更多
As an extension of overlap functions, pseudo-semi-overlap functions are a crucial class of aggregation functions. Therefore, (I, PSO)-fuzzy rough sets are introduced, utilizing pseudo-semi-overlap functions, and furth...As an extension of overlap functions, pseudo-semi-overlap functions are a crucial class of aggregation functions. Therefore, (I, PSO)-fuzzy rough sets are introduced, utilizing pseudo-semi-overlap functions, and further extended for applications in image edge extraction. Firstly, a new clustering function, the pseudo-semi-overlap function, is introduced by eliminating the symmetry and right continuity present in the overlap function. The relaxed nature of this function enhances its applicability in image edge extraction. Secondly, the definitions of (I, PSO)-fuzzy rough sets are provided, using (I, PSO)-fuzzy rough sets, a pair of new fuzzy mathematical morphological operators (IPSOFMM operators) is proposed. Finally, by combining the fuzzy C-means algorithm and IPSOFMM operators, a novel image edge extraction algorithm (FCM-IPSO algorithm) is proposed and implemented. Compared to existing algorithms, the FCM-IPSO algorithm exhibits more image edges and a 73.81% decrease in the noise introduction rate. The outstanding performance of (I, PSO)-fuzzy rough sets in image edge extraction demonstrates their practical application value.展开更多
目的:研究完全腹腔镜胃癌根治术联合overlap吻合术对消化道重建、并发症及患者生活质量的影响。方法:选取2019年6月至2021年12月于蚌埠医学院第一附属医院接受诊治的110例胃癌患者为研究对象。根据不同手术方式分为对照组(传统腹腔镜胃...目的:研究完全腹腔镜胃癌根治术联合overlap吻合术对消化道重建、并发症及患者生活质量的影响。方法:选取2019年6月至2021年12月于蚌埠医学院第一附属医院接受诊治的110例胃癌患者为研究对象。根据不同手术方式分为对照组(传统腹腔镜胃癌根治术,n=60)与观察组(完全腹腔镜胃癌根治术联合overlap吻合术,n=50),比较2组手术疗效及并发症,并采用胃肠道生活质量表(Gastrointestinal Quality of Life,GIQLI)评估生活质量。结果:观察组手术全程用时、消化道重建用时、总失血量均少于对照组(均P<0.05);2组肿瘤大小、淋巴结清扫数比较差异均无统计学意义(均P>0.05)。观察组术后排气时间、流食进食时间、下地时间均少于对照组(均P<0.05);2组住院时间差异无统计学意义(P>0.05)。观察组术后并发症总发生率低于对照组(P<0.05)。随访6个月,2组GIQLI各维度得分及总分均高于出院当天(均P<0.05),观察组GIQLI各维度得分及总分均高于对照组(均P<0.05)。结论:完全腹腔镜胃癌根治术联合overlap吻合术能有效重建消化道,减少并发症,改善生活质量。展开更多
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disease with a significant impact on patients’ quality of life and a high socioeconomic burden. And the understanding of IBS has changed since the r...Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disease with a significant impact on patients’ quality of life and a high socioeconomic burden. And the understanding of IBS has changed since the release of the Rome Ⅳ diagnosis in 2016. With the upcoming Rome Ⅴ revision, it is necessary to review the results of IBS research in recent years. In this review of IBS, we can highlight future concerns by reviewing the results of IBS research on epidemiology, overlap disorders, pathophysiology, and treatment over the past decade and summarizing the latest research.展开更多
As one of the most concerned digital technologies in recent years,blockchain and distributed ledger technology are an important driving force for a new round of technological development.It is currently in the process...As one of the most concerned digital technologies in recent years,blockchain and distributed ledger technology are an important driving force for a new round of technological development.It is currently in the process of accelerating its evolution and maturity,and has gradually integrated with other digital technologies.It has been applied in many industries,providing decentralized solutions for various industries,realizing innovative storage models,and building a new trust system.As blockchain technology is officially incorporated into China’s new information infrastructure category,the application fields of blockchain have expanded rapidly,gradually extending from the financial field and government affairs to other fields in the real economy.At the same time,with the continuous development of the globalized economy,blockchain technology will also have a profound impact on international technological and economic development.Therefore,for the healthy and orderly development and real implementation of the blockchain industry,standardize the application of blockchain,effectively break through the cognitive and technical barriers between different countries,industries and systems on a global scale,prevent application risks,the development of the global blockchain industry needs standardization basis,which is particularly important and urgent.A sound standard system is an important key to the successful development of technology,and formulating the right standard at the right time for technology development helps ensure the ease of use and interoperability of the technology.From the perspective of international standardization,this article first introduces the general situation of ISO,ITU-T,IEEE,W3C and other international standardization organizations,and sorts out the status quo of the blockchain standardization working groups of mainstream international standardization organizations.All blockchain-related standards under development have been analyzed for the characteristics of international blockchain technology standards and industry application standards.Through data analysis,the overlaps,differences and conflicts in the field of international blockchain standard formulation are sorted out,and suggestions for blockchain standardization work in the application and development of blockchain technology standardization by international organizations and industries are put forward.The plans and layouts of future international standards are summarized to help the development of the international standardization of blockchain.展开更多
There are many problems in Social Internet of Things(IoTs),such as complex topology information,different degree of association between nodes and overlapping communities.The idea of set pair information grain computin...There are many problems in Social Internet of Things(IoTs),such as complex topology information,different degree of association between nodes and overlapping communities.The idea of set pair information grain computing and clustering is introduced to solve the above problems so as to accurately describe the similarity between nodes and fully explore the multi-community structure.A Set Pair Three-Way Overlapping Community Discovery Algorithm for Weighted Social Internet of Things(WSIoT-SPTOCD)is proposed.In the local network structure,which fully considers the topological information between nodes,the set pair connection degree is used to analyze the identity,difference and reverse of neighbor nodes.The similarity degree of different neighbor nodes is defined from network edge weight and node degree,and the similarity measurement method of set pair between nodes based on the local information structure is proposed.According to the number of nodes'neighbors and the connection degree of adjacent edges,the clustering intensity of nodes is defined,and an improved algorithm for initial value selection of k-means is proposed.The nodes are allocated according to the set pair similarity between nodes and different communities.Three-way community structures composed of a positive domain,boundary domain and negative domain are generated iteratively.Next,the overlapping node set is generated according to the calculation results of community node membership.Finally,experiments are carried out on artificial networks and real networks.The results show that WSIoT-SPTOCD performs well in terms of standardized mutual information,overlapping community modularity and F1.展开更多
Most modern technologies,such as social media,smart cities,and the internet of things(IoT),rely on big data.When big data is used in the real-world applications,two data challenges such as class overlap and class imba...Most modern technologies,such as social media,smart cities,and the internet of things(IoT),rely on big data.When big data is used in the real-world applications,two data challenges such as class overlap and class imbalance arises.When dealing with large datasets,most traditional classifiers are stuck in the local optimum problem.As a result,it’s necessary to look into new methods for dealing with large data collections.Several solutions have been proposed for overcoming this issue.The rapid growth of the available data threatens to limit the usefulness of many traditional methods.Methods such as oversampling and undersampling have shown great promises in addressing the issues of class imbalance.Among all of these techniques,Synthetic Minority Oversampling TechniquE(SMOTE)has produced the best results by generating synthetic samples for the minority class in creating a balanced dataset.The issue is that their practical applicability is restricted to problems involving tens of thousands or lower instances of each.In this paper,we have proposed a parallel mode method using SMOTE and MapReduce strategy,this distributes the operation of the algorithm among a group of computational nodes for addressing the aforementioned problem.Our proposed solution has been divided into three stages.Thefirst stage involves the process of splitting the data into different blocks using a mapping function,followed by a pre-processing step for each mapping block that employs a hybrid SMOTE algo-rithm for solving the class imbalanced problem.On each map block,a decision tree model would be constructed.Finally,the decision tree blocks would be com-bined for creating a classification model.We have used numerous datasets with up to 4 million instances in our experiments for testing the proposed scheme’s cap-abilities.As a result,the Hybrid SMOTE appears to have good scalability within the framework proposed,and it also cuts down the processing time.展开更多
Symmetric six oxygen-coordinated Mn structural units(MnO6)in MnO2 with small Mn–O orbital overlap hamper electron transfer rates during energy storage.Herein,we report a novel bond angle modulation strategy to manipu...Symmetric six oxygen-coordinated Mn structural units(MnO6)in MnO2 with small Mn–O orbital overlap hamper electron transfer rates during energy storage.Herein,we report a novel bond angle modulation strategy to manipulate Mn–O orbital overlap in MnO2 through the construction of Mn vacancies(MnO2-VMn),aiming at expediting electron transfer,and thus enhancing energy storage performance.Both experimental and theoretical results disclose that the amplification of Mn–O–Mn bond angles exclusively augments the Mn(dx2-y2)-O(py)orbital overlap and triggers the electron redistribution in MnO2-VMn,inducing an augmented Mn dx2-y2 electron occupation.This heightened presence of active electrons in the Mn dx2-y2 orbital paves the way for accelerating electron transfer and ion transfer in MnO2-VMn.Notably,MnO2-VMn delivers an improved specific capacitance of 425 F g−1 at 1 A g−1 and a superior rate capacity of 265 F g−1 at 20 A g−1.Furthermore,an asymmetric supercapacitor(MnO2-VMn//AC ASC)was fabricated,exhibiting a high energy density of 64.3 Wh kg−1 at a power density of 1000 W kg−1.Furthermore,theoretical insights uncover the profound implications of metal–oxygen–metal bond angle regulation on interatomic orbital overlap modulation.These revelations illuminate pathways for the design of advanced energy storage materials.展开更多
文摘BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.
基金supported in part by the Central Government Guides Local Science and TechnologyDevelopment Funds(Grant No.YDZJSX2021A038)in part by theNational Natural Science Foundation of China under(Grant No.61806138)in part by the China University Industry-University-Research Collaborative Innovation Fund(Future Network Innovation Research and Application Project)(Grant 2021FNA04014).
文摘The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the interaction among decision variables is intricate,leading to large group sizes and suboptimal optimization effects;hence a large-scale multi-objective optimization algorithm based on weighted overlapping grouping of decision variables(MOEAWOD)is proposed in this paper.Initially,the decision variables are perturbed and categorized into convergence and diversity variables;subsequently,the convergence variables are subdivided into groups based on the interactions among different decision variables.If the size of a group surpasses the set threshold,that group undergoes a process of weighting and overlapping grouping.Specifically,the interaction strength is evaluated based on the interaction frequency and number of objectives among various decision variables.The decision variable with the highest interaction in the group is identified and disregarded,and the remaining variables are then reclassified into subgroups.Finally,the decision variable with the strongest interaction is added to each subgroup.MOEAWOD minimizes the interactivity between different groups and maximizes the interactivity of decision variables within groups,which contributed to the optimized direction of convergence and diversity exploration with different groups.MOEAWOD was subjected to testing on 18 benchmark large-scale optimization problems,and the experimental results demonstrate the effectiveness of our methods.Compared with the other algorithms,our method is still at an advantage.
基金Supported by National Natural Science Foundation of China,No.82060123National Health Commission of Guizhou Province,No.gzwjk2019-1-082.
文摘BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.
基金Supported by The Guangxi TCM Suitable Technology Development and Promotion Project,No.GZSY20-20.
文摘BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.
基金This work was supported by the National Science Fund for Distinguished Young Scholars(62325104).
文摘The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition can be influenced.For addressing this issue,a method for extracting ship targets with overlaps via the expectation maximization(EM)algorithm is pro-posed.First,the scatterers of ship targets are obtained via the target detection technique.Then,the EM algorithm is applied to extract the scatterers of a single ship target with a single IPP.Afterwards,a novel image amplitude estimation approach is pro-posed,with which the radar image of a single target with a sin-gle IPP can be generated.The proposed method can accom-plish IPP selection and targets separation in the image domain,which can improve the image quality and reserve the target information most possibly.Results of simulated and real mea-sured data demonstrate the effectiveness of the proposed method.
文摘BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related death.METHODS Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort study.Liver-related death or transplantation(liver-related mortality)was determined using a population-based data linkage system.Prognostic scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and AIH-PSC.LOS was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any group.CONCLUSION Survival in the rare,AILDOS is unclear.The current study supports the LOS as a predictor of liver-related mortality in AIH-PBC patients.Further trials investigating predictors of survival in AILDOS are required.
文摘Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.
文摘As an extension of overlap functions, pseudo-semi-overlap functions are a crucial class of aggregation functions. Therefore, (I, PSO)-fuzzy rough sets are introduced, utilizing pseudo-semi-overlap functions, and further extended for applications in image edge extraction. Firstly, a new clustering function, the pseudo-semi-overlap function, is introduced by eliminating the symmetry and right continuity present in the overlap function. The relaxed nature of this function enhances its applicability in image edge extraction. Secondly, the definitions of (I, PSO)-fuzzy rough sets are provided, using (I, PSO)-fuzzy rough sets, a pair of new fuzzy mathematical morphological operators (IPSOFMM operators) is proposed. Finally, by combining the fuzzy C-means algorithm and IPSOFMM operators, a novel image edge extraction algorithm (FCM-IPSO algorithm) is proposed and implemented. Compared to existing algorithms, the FCM-IPSO algorithm exhibits more image edges and a 73.81% decrease in the noise introduction rate. The outstanding performance of (I, PSO)-fuzzy rough sets in image edge extraction demonstrates their practical application value.
文摘目的:研究完全腹腔镜胃癌根治术联合overlap吻合术对消化道重建、并发症及患者生活质量的影响。方法:选取2019年6月至2021年12月于蚌埠医学院第一附属医院接受诊治的110例胃癌患者为研究对象。根据不同手术方式分为对照组(传统腹腔镜胃癌根治术,n=60)与观察组(完全腹腔镜胃癌根治术联合overlap吻合术,n=50),比较2组手术疗效及并发症,并采用胃肠道生活质量表(Gastrointestinal Quality of Life,GIQLI)评估生活质量。结果:观察组手术全程用时、消化道重建用时、总失血量均少于对照组(均P<0.05);2组肿瘤大小、淋巴结清扫数比较差异均无统计学意义(均P>0.05)。观察组术后排气时间、流食进食时间、下地时间均少于对照组(均P<0.05);2组住院时间差异无统计学意义(P>0.05)。观察组术后并发症总发生率低于对照组(P<0.05)。随访6个月,2组GIQLI各维度得分及总分均高于出院当天(均P<0.05),观察组GIQLI各维度得分及总分均高于对照组(均P<0.05)。结论:完全腹腔镜胃癌根治术联合overlap吻合术能有效重建消化道,减少并发症,改善生活质量。
基金National Natural Science Foundation of China,No.81873297the Fundamental Research Funds for the Central Public Welfare Research Institutes,China,No.ZZ13-YQ-006Innovation Fund of Chinese Academy of Chinese Medical Sciences,China,No.CI2021A01003.
文摘Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disease with a significant impact on patients’ quality of life and a high socioeconomic burden. And the understanding of IBS has changed since the release of the Rome Ⅳ diagnosis in 2016. With the upcoming Rome Ⅴ revision, it is necessary to review the results of IBS research in recent years. In this review of IBS, we can highlight future concerns by reviewing the results of IBS research on epidemiology, overlap disorders, pathophysiology, and treatment over the past decade and summarizing the latest research.
基金supported by the Key R&D Program of Zhejiang Province(2021C01105)the Key R&D Program of Guangdong Province(2020B0101090003)+1 种基金the National Key R&D Program of China(2021YFB2701100)These supports are gratefully acknowledged.
文摘As one of the most concerned digital technologies in recent years,blockchain and distributed ledger technology are an important driving force for a new round of technological development.It is currently in the process of accelerating its evolution and maturity,and has gradually integrated with other digital technologies.It has been applied in many industries,providing decentralized solutions for various industries,realizing innovative storage models,and building a new trust system.As blockchain technology is officially incorporated into China’s new information infrastructure category,the application fields of blockchain have expanded rapidly,gradually extending from the financial field and government affairs to other fields in the real economy.At the same time,with the continuous development of the globalized economy,blockchain technology will also have a profound impact on international technological and economic development.Therefore,for the healthy and orderly development and real implementation of the blockchain industry,standardize the application of blockchain,effectively break through the cognitive and technical barriers between different countries,industries and systems on a global scale,prevent application risks,the development of the global blockchain industry needs standardization basis,which is particularly important and urgent.A sound standard system is an important key to the successful development of technology,and formulating the right standard at the right time for technology development helps ensure the ease of use and interoperability of the technology.From the perspective of international standardization,this article first introduces the general situation of ISO,ITU-T,IEEE,W3C and other international standardization organizations,and sorts out the status quo of the blockchain standardization working groups of mainstream international standardization organizations.All blockchain-related standards under development have been analyzed for the characteristics of international blockchain technology standards and industry application standards.Through data analysis,the overlaps,differences and conflicts in the field of international blockchain standard formulation are sorted out,and suggestions for blockchain standardization work in the application and development of blockchain technology standardization by international organizations and industries are put forward.The plans and layouts of future international standards are summarized to help the development of the international standardization of blockchain.
文摘There are many problems in Social Internet of Things(IoTs),such as complex topology information,different degree of association between nodes and overlapping communities.The idea of set pair information grain computing and clustering is introduced to solve the above problems so as to accurately describe the similarity between nodes and fully explore the multi-community structure.A Set Pair Three-Way Overlapping Community Discovery Algorithm for Weighted Social Internet of Things(WSIoT-SPTOCD)is proposed.In the local network structure,which fully considers the topological information between nodes,the set pair connection degree is used to analyze the identity,difference and reverse of neighbor nodes.The similarity degree of different neighbor nodes is defined from network edge weight and node degree,and the similarity measurement method of set pair between nodes based on the local information structure is proposed.According to the number of nodes'neighbors and the connection degree of adjacent edges,the clustering intensity of nodes is defined,and an improved algorithm for initial value selection of k-means is proposed.The nodes are allocated according to the set pair similarity between nodes and different communities.Three-way community structures composed of a positive domain,boundary domain and negative domain are generated iteratively.Next,the overlapping node set is generated according to the calculation results of community node membership.Finally,experiments are carried out on artificial networks and real networks.The results show that WSIoT-SPTOCD performs well in terms of standardized mutual information,overlapping community modularity and F1.
文摘Most modern technologies,such as social media,smart cities,and the internet of things(IoT),rely on big data.When big data is used in the real-world applications,two data challenges such as class overlap and class imbalance arises.When dealing with large datasets,most traditional classifiers are stuck in the local optimum problem.As a result,it’s necessary to look into new methods for dealing with large data collections.Several solutions have been proposed for overcoming this issue.The rapid growth of the available data threatens to limit the usefulness of many traditional methods.Methods such as oversampling and undersampling have shown great promises in addressing the issues of class imbalance.Among all of these techniques,Synthetic Minority Oversampling TechniquE(SMOTE)has produced the best results by generating synthetic samples for the minority class in creating a balanced dataset.The issue is that their practical applicability is restricted to problems involving tens of thousands or lower instances of each.In this paper,we have proposed a parallel mode method using SMOTE and MapReduce strategy,this distributes the operation of the algorithm among a group of computational nodes for addressing the aforementioned problem.Our proposed solution has been divided into three stages.Thefirst stage involves the process of splitting the data into different blocks using a mapping function,followed by a pre-processing step for each mapping block that employs a hybrid SMOTE algo-rithm for solving the class imbalanced problem.On each map block,a decision tree model would be constructed.Finally,the decision tree blocks would be com-bined for creating a classification model.We have used numerous datasets with up to 4 million instances in our experiments for testing the proposed scheme’s cap-abilities.As a result,the Hybrid SMOTE appears to have good scalability within the framework proposed,and it also cuts down the processing time.
基金Financial support from the National Natural Science Foundation of China(21575016U20A20154+1 种基金22279005)the National Program for Support of Top-notch Young Professionals。
文摘Symmetric six oxygen-coordinated Mn structural units(MnO6)in MnO2 with small Mn–O orbital overlap hamper electron transfer rates during energy storage.Herein,we report a novel bond angle modulation strategy to manipulate Mn–O orbital overlap in MnO2 through the construction of Mn vacancies(MnO2-VMn),aiming at expediting electron transfer,and thus enhancing energy storage performance.Both experimental and theoretical results disclose that the amplification of Mn–O–Mn bond angles exclusively augments the Mn(dx2-y2)-O(py)orbital overlap and triggers the electron redistribution in MnO2-VMn,inducing an augmented Mn dx2-y2 electron occupation.This heightened presence of active electrons in the Mn dx2-y2 orbital paves the way for accelerating electron transfer and ion transfer in MnO2-VMn.Notably,MnO2-VMn delivers an improved specific capacitance of 425 F g−1 at 1 A g−1 and a superior rate capacity of 265 F g−1 at 20 A g−1.Furthermore,an asymmetric supercapacitor(MnO2-VMn//AC ASC)was fabricated,exhibiting a high energy density of 64.3 Wh kg−1 at a power density of 1000 W kg−1.Furthermore,theoretical insights uncover the profound implications of metal–oxygen–metal bond angle regulation on interatomic orbital overlap modulation.These revelations illuminate pathways for the design of advanced energy storage materials.
